title: Balancing efficacy against safety in sublingual immunotherapy with inhalant allergens: what is the best approach?
abstract: Over the last 20 years, studies and clinical trials have demonstrated efficacy, safety and cost-effectiveness of sublingual immunotherapy (SLIT) for respiratory allergic diseases. Nevertheless, it seems to be mostly used as a second-line therapeutic option, and adherence to treatment is not always optimal. Selective literature research was done in Medline and PubMed, including guidelines, position papers and Cochrane meta-analyses concerning SLIT in adult patients. The most recent reviews confirm SLIT as viable and efficacious treatment especially for allergic rhinitis, even if the optimal dosage, duration, schedule are not clearly established for most of the products. Despite an optimal safety profile, tolerability and patient-reported outcomes concerning SLIT have received poor attention until now. Recently, new tools have been specifically developed in order to investigate these aspects. Regular assessment of tolerability profile and SLIT-related patient-reported outcomes will allow balancing efficacy with tolerability and all the other patient-related variables that may affect treatment effectiveness beyond its efficacy.
authors.affiliation: Allergy Unit, Verona University Hospital, Piazzale Aristide Stefani 1, 37126 Verona, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Caminati
authors.forename: Annarita
authors.initials: A
authors.lastname: Dama
authors.forename: Michele
authors.initials: M
authors.lastname: Schiappoli
authors.forename: Gianenrico
authors.initials: G
authors.lastname: Senna
mesh_terms: D000286:Administration, Sublingual; D000328:Adult; D000485:Allergens / Q000009:adverse effects / Q000276:immunology; D000818:Animals; D003888:Desensitization, Immunologic / Q000379:methods* / Q000639:trends; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects; D055118:Medication Adherence; D019055:No-Observed-Adverse-Effect Level; D012221:Rhinitis, Allergic, Perennial / Q000276:immunology* / Q000628:therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000276:immunology* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000485:Allergens